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- Title
A frailty index predicts post-liver transplant morbidity and mortality in HIV-positive patients.
- Authors
Guaraldi, Giovanni; Dolci, Giovanni; Zona, Stefano; Tarantino, Giuseppe; Serra, Valentina; Ballarin, Roberto; Franceschini, Erica; Codeluppi, Mauro; Brothers, Thomas D.; Mussini, Cristina; Di Benedetto, Fabrizio
- Abstract
Background: We hypothesized that frailty acts as a measure of health outcomes in the context of LT. The aim of this study was to explore frailty index across LT, as a measure of morbidity and mortality. This was a retrospective observational study including all consecutive 47 HIV+patients who received LT in Modena, Italy from 2003 to June 2015. Methods: frailty index (FI) was constructed from 30 health variables. It was used both as a continuous score and as a categorical variable, defning 'most frail' a FI > 0.45. FI change across transplant (deltaFI, ΔFI) was calculated as the diference between year 1 FI (FI-Y1) and pre-transplant FI (FI-t0). The outcomes measures were mortality and "otpimal LT" (defned as being alive without multi-morbidity). Results: Median value of FI-t0 was 0.48 (IQR 0.42-0.52), FI-Y1 was 0.31 (IQR 0.26-0.41). At year fve mortality rate was 45%, "optimal transplant" rate at year 1 was 38%. All the patients who died in the post-LT were most frail in the pre-LT. ΔFI was a predictor of mortality after correction for age and MELD (HR = 1.10, p = 0.006) and was inversely associated with optimal transplant after correction for age (HR = 1.04, p = 0.01). Conclusions: We validated FI as a valuable health measure in HIV transplant. In particular, we found a relevant correlation between FI strata at baseline and mortality and a statistically significant correlation between, ΔFI and survival rate.
- Subjects
ITALY; HIV infections; HIV-positive persons; LIVER transplantation; EVALUATION of medical care; SCIENTIFIC observation; PROBABILITY theory; PRE-tests &; post-tests; RETROSPECTIVE studies; DESCRIPTIVE statistics
- Publication
AIDS Research & Therapy, 2017, Vol 14, p1
- ISSN
1742-6405
- Publication type
Article
- DOI
10.1186/s12981-017-0163-x